Combined Orthoplastic Approach in Fracture-Related Infections of the Distal Tibia
This series reports on the treatment of distal tibia (DT) fracture-related infections (FRI) with a combined orthoplastic approach. Thirteen patients were included. In eight patients with extensive bone involvement and in those with a non-healed fracture, the DT was resected (“staged approach”). In f...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-08-01
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| Series: | Microorganisms |
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| Online Access: | https://www.mdpi.com/2076-2607/10/8/1640 |
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| author | Andrea Sambri Marco Pignatti Sara Tedeschi Maria Elisa Lozano Miralles Claudio Giannini Michele Fiore Matteo Filippini Riccardo Cipriani Pierluigi Viale Massimiliano De Paolis |
| author_facet | Andrea Sambri Marco Pignatti Sara Tedeschi Maria Elisa Lozano Miralles Claudio Giannini Michele Fiore Matteo Filippini Riccardo Cipriani Pierluigi Viale Massimiliano De Paolis |
| author_sort | Andrea Sambri |
| collection | DOAJ |
| description | This series reports on the treatment of distal tibia (DT) fracture-related infections (FRI) with a combined orthoplastic approach. Thirteen patients were included. In eight patients with extensive bone involvement and in those with a non-healed fracture, the DT was resected (“staged approach”). In five cases, the DT was preserved (“single-stage approach”). A wide debridement was performed, and the cavity was filled with antibiotic-loaded PerOssal beads. All patients had a soft-tissue defect covered by a free vascularized flap (anterolateral thigh perforator flap in eight cases, latissimus dorsi flap in five). At the final follow-up (mean 25 months, range, 13–37), no infection recurrence was observed. In one patient, the persistence of infection was observed, and the patient underwent a repeated debridement. In two cases, a voluminous hematoma was observed. However, none of these complications impacted the final outcome. The successful treatment of FRI depends on proper debridement and obliteration of dead spaces with a flap. Therefore, when dealing with DT FRI, debridement of infected bone and soft tissues must be as radical as required, with no fear of the need for massive reconstructions. |
| first_indexed | 2024-03-09T12:53:52Z |
| format | Article |
| id | doaj.art-672962fe15ee41cc8444ccba225b8f52 |
| institution | Directory Open Access Journal |
| issn | 2076-2607 |
| language | English |
| last_indexed | 2024-03-09T12:53:52Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Microorganisms |
| spelling | doaj.art-672962fe15ee41cc8444ccba225b8f522023-11-30T22:02:19ZengMDPI AGMicroorganisms2076-26072022-08-01108164010.3390/microorganisms10081640Combined Orthoplastic Approach in Fracture-Related Infections of the Distal TibiaAndrea Sambri0Marco Pignatti1Sara Tedeschi2Maria Elisa Lozano Miralles3Claudio Giannini4Michele Fiore5Matteo Filippini6Riccardo Cipriani7Pierluigi Viale8Massimiliano De Paolis9Orthopaedics Unit, IRCCS AOU di Bologna, 40138 Bologna, ItalyPlastic Surgery Unit, IRCCS AOU di Bologna, 40138 Bologna, ItalyDepartment of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, ItalyPlastic Surgery Unit, IRCCS AOU di Bologna, 40138 Bologna, ItalyOrthopaedics Unit, IRCCS AOU di Bologna, 40138 Bologna, ItalyOrthopaedics Unit, IRCCS AOU di Bologna, 40138 Bologna, ItalyOrthopaedics Unit, IRCCS AOU di Bologna, 40138 Bologna, ItalyPlastic Surgery Unit, IRCCS AOU di Bologna, 40138 Bologna, ItalyDepartment of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, ItalyOrthopaedics Unit, IRCCS AOU di Bologna, 40138 Bologna, ItalyThis series reports on the treatment of distal tibia (DT) fracture-related infections (FRI) with a combined orthoplastic approach. Thirteen patients were included. In eight patients with extensive bone involvement and in those with a non-healed fracture, the DT was resected (“staged approach”). In five cases, the DT was preserved (“single-stage approach”). A wide debridement was performed, and the cavity was filled with antibiotic-loaded PerOssal beads. All patients had a soft-tissue defect covered by a free vascularized flap (anterolateral thigh perforator flap in eight cases, latissimus dorsi flap in five). At the final follow-up (mean 25 months, range, 13–37), no infection recurrence was observed. In one patient, the persistence of infection was observed, and the patient underwent a repeated debridement. In two cases, a voluminous hematoma was observed. However, none of these complications impacted the final outcome. The successful treatment of FRI depends on proper debridement and obliteration of dead spaces with a flap. Therefore, when dealing with DT FRI, debridement of infected bone and soft tissues must be as radical as required, with no fear of the need for massive reconstructions.https://www.mdpi.com/2076-2607/10/8/1640orthoplasticdistal tibiafree flapchronic osteomyelitisallograftarthrodesis |
| spellingShingle | Andrea Sambri Marco Pignatti Sara Tedeschi Maria Elisa Lozano Miralles Claudio Giannini Michele Fiore Matteo Filippini Riccardo Cipriani Pierluigi Viale Massimiliano De Paolis Combined Orthoplastic Approach in Fracture-Related Infections of the Distal Tibia Microorganisms orthoplastic distal tibia free flap chronic osteomyelitis allograft arthrodesis |
| title | Combined Orthoplastic Approach in Fracture-Related Infections of the Distal Tibia |
| title_full | Combined Orthoplastic Approach in Fracture-Related Infections of the Distal Tibia |
| title_fullStr | Combined Orthoplastic Approach in Fracture-Related Infections of the Distal Tibia |
| title_full_unstemmed | Combined Orthoplastic Approach in Fracture-Related Infections of the Distal Tibia |
| title_short | Combined Orthoplastic Approach in Fracture-Related Infections of the Distal Tibia |
| title_sort | combined orthoplastic approach in fracture related infections of the distal tibia |
| topic | orthoplastic distal tibia free flap chronic osteomyelitis allograft arthrodesis |
| url | https://www.mdpi.com/2076-2607/10/8/1640 |
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